国产长春瑞滨持续静脉输注治疗晚期食管癌的临床观察

The clinical study of continuous intravenous infusion vinorelbine with cisplatin for advanced esophageal cancer

目的:探讨小剂量国产长春瑞滨(NVB)持续静脉输注联合顺铂(PDD)治疗晚期食管癌的疗效与安全性。方法:NVB首剂10mg静脉推注,接用NVB10mg静脉持续滴注24小时,第1～5天;PDD30mg/m2静脉滴注2小时,第1～3天。21天为1周期,2周期后评价疗效。结果:27例共化疗61周期,平均2.3周期。食管原发病灶有效率为40.7%,吞咽功能得到改善的患者占92.3%。转移病灶缓解率为42.0%,其中淋巴结转移的有效率较高(66.7%)。总的中位生存期为10个月(5～19个月)。主要不良反应为血液学毒性和消化道反应,Ⅲ～Ⅳ度白细胞下降为35.4%,恶心呕吐发生率41.3%,末梢神经炎10.2%。结论:NVB持续输注联合PDD方案治疗晚期难治性食管癌,近期疗效较好,毒副反应轻,值得进一步临床研究。

Objective:To evaluate the efficacy and toxicity of continuous infusion vinorelbine combined with cisplatin for advanced esophageal cancer.Methods:NVB 10mg bolus followed by NVB 10mg continuous infusion for 24h, day 1～5. PDD 30mg/m^2 iv 2h, day 1～3;repeated every three weeks. After two cycles, we evaluated the efficacy and toxicity interval of one month.Results:27 patients received 61 cycles therapy, average 2.3 cycles. The response rate of primary esophageal cancer was 40.7%, and the deglutition function improved 92.3% among these. The overall response rate of metastasis tumour was 42%, and the response rate of lymph node metastasis was higher than other's(66.7). The overall median survival was 10 months (5～19 months). The primary toxicities were digestive tract toxicity, end-brush neurotoxicity and myelosuppression. Ⅲ～Ⅳ grade granulodytopenia was 35.4%, vomiting was 41.3% and end-brush neurotoxicity was 10.2%.Conclusion:The treatment of vinorelbine continuous infusion for advanced esophageal cancer had higher efficacy and lower side effect, and it will be deserved further investigation.